Federal Court Reinstates Vaccine Injury Compensation for Multiple Sclerosis Patient in Landmark Ruling

Decision Expands Legal Path for Vaccine Injury Claims Based on Aggravation of Pre-Existing Conditions

The United States Court of Appeals for the Federal Circuit has ruled in favor of Elizabeth Doles, a woman who claimed that two vaccines significantly worsened her previously undiagnosed multiple sclerosis (MS). The April 23, 2025, decision reverses a lower court ruling and reinstates her right to compensation under the National Vaccine Injury Compensation Program (VICP). The case now returns to the Court of Federal Claims for a final determination of how much she will receive.

The Court found that Doles provided enough evidence to show that her condition was significantly aggravated by the Tdap and polio vaccines she received in 2016. Importantly, the Court clarified that claimants in the VICP do not need to prove medical causation with scientific certainty. Instead, they only need to show it is “more likely than not” that a vaccine caused or worsened their condition.

“This ruling is a major step forward for people whose pre-existing conditions may have been made worse by a vaccine,” said Jennifer Maglio, one of the attorneys at mctlaw representing Ms. Doles. “It reinforces what the Vaccine Act is meant to do, make sure people who are injured by vaccines receive fair compensation, even when their injuries are complex.”

Background of the Case

Elizabeth Doles was 67 years old when she received the polio and Tdap vaccines in preparation for joining the Peace Corps. Soon afterward, she began experiencing neurological symptoms that were later diagnosed as multiple sclerosis. She filed a petition in the Vaccine Court alleging that the vaccines either triggered or worsened her MS, which had previously been undiagnosed and symptom-free.

The case was initially heard by a Special Master who ruled in her favor, citing both expert medical testimony and a well-regarded scientific study, conducted by Langer-Gould and colleagues using data from the Kaiser health system, that suggested vaccines may accelerate symptom onset in people with underlying, silent autoimmune conditions. However, the U.S. Court of Federal Claims later reversed that decision, stating that the study did not apply to Doles because she was over 50 and the study’s main findings involved younger patients.

The Federal Circuit firmly rejected that argument.

What the Federal Circuit Ruled

The Court found that the lower court wrongly imposed a higher standard of proof than the Vaccine Act requires. In its opinion, the Federal Circuit emphasized:

• Statistical certainty is not required for evidence in VICP cases.
• Medical theories of causation can be supported by circumstantial evidence and expert opinion.
• Special Masters have broad discretion to weigh evidence and make credibility decisions, and their findings should be credited.

The ruling restores the original finding by Special Master Horner that Doles met all six factors required under the Loving test, a legal framework used to evaluate whether a vaccine significantly aggravated a pre-existing condition.

Why This Matters for Future Vaccine Injury Cases

This ruling has wide-reaching implications for current and future VICP claims:

• Easier Path for Aggravation Cases: Claimants who have a pre-existing condition that becomes worse after vaccination may now have a clearer legal path to compensation.
• Broader Use of Medical Literature: Scientific studies that show possible, but not definitive, connections between vaccines and injuries may still be valid evidence under the law.
• Reinforces Vaccine Court Standards: The ruling reminds both attorneys and judges that the VICP uses a lower burden of proof than scientific or academic research.

“This case underscores the importance of looking at the total picture,” said Joseph Vuckovich, a leading vaccine injury attorney who also represented Doles. “We’re grateful that the Court reaffirmed that the standard under the Vaccine Act is fairness, not perfection

About the Vaccine Injury Compensation Program (VICP)

The VICP was created by Congress in 1986 to provide compensation to people who are injured by certain routine vaccinations. Claims are filed in a specialized court known as the U.S. Court of Federal Claims. The program is no-fault, meaning claimants don’t need to prove anyone was negligent—only that it’s more likely than not the vaccine caused the injury or significantly worsened an existing condition.

What Happens Next

The case will now return to the U.S. Court of Federal Claims to determine how much compensation Doles will receive. The Federal Circuit’s decision sets a new benchmark that may impact how other vaccine-related cases are handled moving forward.